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Blood Test Tracker

Urine MDMA (Ecstasy) Screen

A urine screen for MDMA (ecstasy or molly) and closely related drugs. A positive result is presumptive until a second test confirms it.

AI-verified against cited sources. Awaiting expert reviewAlso called MDMALOINC 19568-5

What it is

MDMA is a stimulant with mood-altering effects. It is often called ecstasy or molly and is most often used recreationally. This screen looks for MDMA and closely related compounds such as MDA, which is also a drug in its own right and a breakdown product of MDMA. It is an immunoassay read against a set cutoff. A regular amphetamine screen is a different test and can miss MDMA.

Why it matters

This test is used in emergency care, in treatment programs, and as part of larger drug panels. Because the screen can react to look-alike medicines, a positive result is read together with your medicine list, and a confirmation test is used when the answer matters.

If it’s high

A positive result means the screen found MDMA or a closely related compound at or above the lab's cutoff. It cannot show how much was taken or when. A look-alike medicine can also cause a false positive, so a confirmation test is often used.

Common causes

  • Use of MDMA (ecstasy or molly)
  • Use of a closely related drug, such as MDA or MDEA
  • A false positive from a look-alike medicine; mebeverine, an antispasmodic used in some countries, has been reported to do this
  • A lab or sample mix-up (rare)

What can help

  • Give your clinician or the lab a full list of your medicines and supplements, including any bought abroad
  • Ask whether a confirmation test (GC-MS or LC-MS/MS) was done or can be added
  • Ask which assay and cutoff the lab used

What can affect your result

  • The assay and its cutoff; the federal workplace cutoff is 500 ng/mL, and some assays offer 300 or 500 ng/mL
  • How long ago MDMA was taken, how much, and how often
  • How dilute the urine is
  • Look-alike medicines that react with the screen
  • Whether the lab runs a separate amphetamine test, which does not reliably detect MDMA
  • Look-alike chemicals can cause a false positive. The antispasm medicine mebeverine, used in some countries, has been reported to do this on an MDMA screen.
  • An amphetamine screen is a separate test. In one MDMA assay, amphetamine and methamphetamine barely react, so a negative amphetamine screen does not rule out MDMA, and the reverse is also true.
  • Very dilute urine can push a drug level below the cutoff.
  • Cutoffs and assays differ between labs, so the same sample can read differently at different labs.

Any time of day. Collection is sometimes supervised in treatment, workplace and legal settings. Reflects recent use. How long a drug can be found in urine depends on the dose, how often it was used and the person.

When to talk to a clinician

A screen result on its own is not an emergency. If you or someone with you has a very high temperature, confusion, a seizure, chest pain, trouble breathing, or can't be woken after taking a drug, call 911 or your local emergency number.

Questions you could ask

  • Is MDMA on my regular drug screen panel, or was this a separate order?
  • Was my sample sent for a confirmation test?
  • Could any medicine or supplement I take explain this result?
  • What cutoff did the lab use?

Questions people ask

If my amphetamine test was negative, can MDMA still show up?

Yes. MDMA has its own test. One MDMA assay barely reacts with amphetamine or methamphetamine, and an amphetamine screen is built to find those drugs instead. Check which tests your panel includes.

Can a medicine cause a false-positive MDMA screen?

Yes, it has been reported. Mebeverine, used for gut cramps in some countries, is one example. Tell the person who ordered the test about every medicine you take, and ask whether a confirmation test is possible.

Show the science and sources

For clinicians and researchers

MDMA immunoassays use antibodies raised against MDMA-type compounds. The Emit II Plus Ecstasy assay is cleared with a 300 or 500 ng/mL cutoff, and the Randox Ecstasy (MDMA) assay uses 500 ng/mL. In the Emit labeling, MDA and MDEA at about 284 to 286 ng/mL give a response equal to the 300 ng/mL cutoff, while d-amphetamine and d-methamphetamine need more than 12,000 ng/mL, so related methylenedioxy drugs are detected and ordinary amphetamines mostly are not. The HHS federal workplace urine panel groups MDMA/MDA with a 500 ng/mL initial cutoff and 250 ng/mL confirmatory cutoffs for MDMA and for MDA, kept apart from the amphetamine/methamphetamine group (also 500 initial, 250 confirmatory). Confirmation is by GC-MS or LC-MS/MS. A published case report links mebeverine to a false-positive MDMA screen, and a 2014 review covers other cross-reactants in drug-of-abuse immunoassays.

LOINC 19568-5 (primary), 113336-2, 14267-9, 19569-3, 112745-5. Specimen: urine.

Sources

  1. Mandatory Guidelines for Federal Workplace Drug Testing Programs: Authorized Testing Panels (91 FR 12308), HHS / SAMHSA, via the Federal Register (2026)
  2. CDC Clinical Practice Guideline for Prescribing Opioids for Pain, United States, 2022, MMWR Recommendations and Reports (CDC) (2022)
  3. Emit II Plus Ecstasy Assay (510(k) K043028), U.S. Food and Drug Administration, 510(k) review document (2005)
  4. Randox Ecstasy (MDMA) Assay (510(k) K092275), U.S. Food and Drug Administration, 510(k) review document (2011)
  5. False-positive urine screen test for MDMA in a patient exposed to mebeverine, British Journal of Clinical Pharmacology (2021)
  6. False-positive interferences of common urine drug screen immunoassays: a review, Journal of Analytical Toxicology (2014)
  7. Drug Testing (MedlinePlus Medical Test), MedlinePlus, U.S. National Library of Medicine

AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.

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